a Department of Interventional Radiology , Patras University Hospital, School of Medicine , Rion , Greece.
b Department of Interventional Radiology , Guy's and St. Thomas' Hospitals, NHS Foundation Trust, King's Health Partners , London , UK.
Expert Rev Med Devices. 2018 Apr;15(4):283-291. doi: 10.1080/17434440.2018.1454311. Epub 2018 Mar 21.
Thrombosis is the most important access-related complication. Several declotting procedures have been suggested falling mainly into two categories; thrombolysis-dependent and thrombectomy-dependent.
Seventeen studies after 2001 have been published on percutaneous treatment of thrombosed vascular access. Authors performed a systematic review of these studies together with a parametric meta-analysis of data available investigating clinical success, postintervention assisted primary patency (PAPP) and independent factors that could influence outcome measures.
A shift to thrombectomy-dependent procedures is observed with a view to diminishing complications from the use of thrombolytic agents. Arteriovenous fistulas provide significantly better PAPP, while newer studies show improved, non-significant results compared with older ones. The role of improvement of devices for subsequent angioplasty is of equal importance, if not more, for improved declotting results.
血栓形成是最重要的与通路相关的并发症。已经提出了几种溶栓程序，主要分为两类：依赖溶栓和依赖血栓切除术。
2001 年后发表了 17 项关于经皮治疗血栓形成血管通路的研究。作者对这些研究进行了系统评价，并对可获得的数据进行了参数荟萃分析，以调查临床成功率、干预后辅助原发性通畅率（PAPP）以及可能影响结果测量的独立因素。
人们越来越倾向于采用依赖于血栓切除术的方法，以减少溶栓药物使用带来的并发症。动静脉瘘提供了更好的 PAPP，而较新的研究显示，与旧研究相比，结果有所改善，但无统计学意义。如果不是更重要的话，用于随后血管成形术的设备的改进对于改善溶栓效果同样重要。
